Korean J Radiol.  2009 Dec;10(6):632-634. 10.3348/kjr.2009.10.6.632.

18F-Fluorodeoxyglucose PET/CT in a Patient with Esophageal and Genital Leiomyomatosis

• An YS
• Kim DY

• KMID: 1102567
• DOI: http://doi.org/10.3348/kjr.2009.10.6.632

Abstract

Diffuse esophageal leiomyomatosis is a rare benign tumor, which can be associated with leiomyoma in female genital tracts involving the uterus, vagina, and vulva. Alport syndrome, an inherited disorder that includes the kidneys, eyes, and sensorineural hearing loss, is also rarely associated with these multiple leiomyomatosis. In our case, 18F-fluoroseoxyglucose positron emission tomography/computed tomography was used to distinguish esophageal and genital leiomyomatosis from malignant masses.

Keyword

Leiomyomatosis; Esophagus; Genital tract; 18F-FDG PET

MeSH Terms

Diagnosis, Differential
Esophageal Neoplasms/*radiography/*radionuclide imaging
Female
Fluorodeoxyglucose F18/diagnostic use
Genital Neoplasms, Female/*radiography/*radionuclide imaging
Humans
Leiomyomatosis/*radiography/*radionuclide imaging
Middle Aged
Positron-Emission Tomography/*methods
Radiographic Image Interpretation, Computer-Assisted
Radiopharmaceuticals/diagnostic use
Tomography, X-Ray Computed/*methods

Figure

• 

  Fig. 1 Esophageal and genital leiomyomatosis A. Huge abnormal increased 18F-FDG uptake lesion (arrows) in esophagus (maximal SUV: 3.8) noted on PET/CT image (upper row). Corresponding contrast enhanced CT images demonstrate abnormal mass lesions in each organ. B. Hypermetabolic lesions (arrows) were evident in pelvic region including uterus (maximal SUV: 6.13) (middle row). C. Hypermetabolic lesions (arrows) were evident in vulvar region (maximal SUV: 2.81) (lower row). D. Arrows point to lesions evident in on PET. E-J. Pathologic examination. Grossly, 13 cm (length)×8 cm (width)×6 cm (depth) poorly circumscribed, sausage-like, white/pink, firm muscular mass oriented across distal esophagus and gastric cardia was evident. Diffusely thickened esophageal wall measured 2 cm in maximal thickness (E). Histologically, Hematoxylin & Eosin staining (×40 in panel F, ×200 in panel G) reveals characteristics of leiomyoma. Multiple confluent well-differentiated smooth muscle proliferations were evident. Cells formed fascicles and interlacing bundles without cytologic atypia. Immunostaining for smooth-muscle actin (×40) was strongly positive in smooth-muscle origin tumor cells with control reaction of microvillous projections in apical cell membrane (H). Uterus lesion also demonstrates as leiomyoma pattern in Hematoxylin & Eosin staining (×100 in panel I, ×400 in panel J).

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